Mouthrinses and dental caries

Abstract

M. Brecx, Brussels, BelgiumMouthrinsing for the prevention of dental caries in children and adolescents was established as a mass prophylactic method in the 1960s and has shown average efficacy of caries reduction between 20-50%. Commonly, weekly or twice monthly rinsing procedures using neutral 0.2% NaF solutions have been used in schools or institutions in areas with low fluoride concentrations in the drinking water. Today, when dental caries has declined substantially in the western countries, and relatively few individuals are suffering from caries, the efficiency of large scale mouth rinsing is questioned and more individual approaches of caries prevention strategies are needed. For this reason individual caries risk assessments are necessary, utilising diagnostic tools with the aim of explaining the main causes of the caries disease. Therefore in high risk patients, daily mouth rinses using 0.05% NaF can be recommended combined with other selective preventive measures such as sugar restriction, improved oral hygiene, antibacterial treatments, and so forth. Mouthrinsing solutions have therefore been combined with antiplaque agents like chlorhexidine and other agents which can improve the caries preventive effect not only in high caries risk patients, including those with dry mouth problems and root caries. Other agents than sodium fluoride have been used, such as stannous and amine fluoride with proven clinical effects. However, although a series of new formulas of mouthrinses containing fluoride combined with different antiplaque agents have shown promising antibacterial and antiplaque efficacy, their long term clinical effects are sparsely documented. Acute and chronic side effects from established and recommended mouth rinsing routines are extremely rare but ethanol containing products should not be recommended to children for long term use or to individuals with alcohol problems. Patients with dry mouth problems should avoid mouthrinses containing high concentration of detergent components which reduce the substantivity of the agent and worsen the dry mouth effect. For the future, patients, dentists and public health officials will welcome new and safe, controlled and self-administrated mouth rinsing procedures with not only high efficacy, but also high effectivity and efficiency.

Salivary fluoride concentration and retention after rinsing with 0.05 and 0.2% sodium fluoride (NaF) compared with a new high F rinse containing 0.32% NaF

“…There are a substantial number of clinical studies showing the additional caries preventive effect of F rinsing to complement daily use of F toothpaste [11,12]. For example, a 3-year randomized controlled trial of school-based F mouthrinsing (0.2% NaF) among 13-to 16-year-olds (n ¼ 622), using toothpaste at home, was carried out in Sweden 1999-2003 [22].…”

“…The most commonly used concentration for adults and the elderly is 0.2% sodium fluoride (NaF) (900 ppm F) for daily rinsing [9,10]. Lower concentrations (0.05% NaF; 225 ppm F) however, are recommended for children <12 years and this is the standard concentration in many countries [11,12].…”

Coffee pulp: From a by-product of coffee production to a potential anticariogenic mouth rinse! An in vivo study

“…[ 2 , 3 ] Mouth rinsing was established as a mass prophylactic method for the prevention of dental caries in children and adolescents in the 1960s and has shown average efficacy of caries reduction of between 20% and 50%. [ 4 ] A variety of synthetic antimicrobial mouthwashes are available which have been shown to inhibit plaque formation, reduce gingival inflammation, and also prevent dental caries. Despite reducing plaque, chlorhexidine (the most commonly used mouth rinse) does not concurrently reduce caries as concluded by a Cochrane review which considered eight clinical trials in adolescents and children.…”